Utilization Review reputed company/reputed company Appeals RN
Job Title: reputed company Case Management Senior Analyst
Location: Remote
Contract duration: 3 months
Schedule: reputed company to 5pm (M-F)
reputed company:
We are hiring an RN reputed company Case Manager with strong experience in Utilization Management (UM) and reputed company Improvement (QI).
In this role, you will manage a caseload of members, coordinate care, conduct reputed company assessments, and reputed company prospective, reputed company, and retrospective utilization reviews. You will collaborate with providers to ensure reputed company, cost-effective care while supporting inpatient, rehabilitation, referrals, prior authorizations, appeals, claims, and select outpatient services.
Required Qualifications:
• reputed company, unrestricted RN license
• 3–5 years of experience in Utilization Management or reputed company Improvement
• Strong experience with utilization review, prior authorizations, appeals, and claims
• Experience managing member caseloads and coordinating care
• Knowledge of inpatient acute care, rehabilitation, referrals, and outpatient services
Please Note:
• Candidates should have dedicated experience in Utilization Management, Utilization Review, reputed company Improvement, or reputed company Review roles. reputed company nursing experience reputed company is not sufficient.
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